Clinical experience with intensity modulated radiation therapy (IMRT) in prostate cancer Journal Article
| Authors: | Zelefsky, M. J.; Fuks, Z.; Happersett, L.; Lee, H. J.; Ling, C. C.; Burman, C. M.; Hunt, M.; Wolfe, T.; Venkatraman, E. S.; Jackson, A.; Skwarchuk, M.; Leibel, S. A. |
| Article Title: | Clinical experience with intensity modulated radiation therapy (IMRT) in prostate cancer |
| Abstract: | Purpose: To compare acute and late toxicities of high-dose radiation for prostate cancer delivered by either conventional three-dimensional conformal radiation therapy (3D-CRT) or intensity modulated radiation therapy (IMRT). Materials and methods: Between September 1992 and February 1998, 61 patients with clinical stage T1c- T3 prostate cancer were treated with 3D-CRT and 171 with IMRT to a prescribed dose of 81 Gy. To quantitatively evaluate the differences between conventional 3D-CRT and IMRT, 20 randomly selected patients were planned concomitantly by both techniques and the resulting treatment plans were compared. Acute and late radiation-induced morbidity was evaluated in all patients and graded according to the Radiation Therapy Oncology Group toxicity scale. Results: Compared with conventional 3D-CRT, IMRT improved the coverage of the clinical target volume (CTV) by the prescription dose and reduced the volumes of the rectal and bladder walls carried to high dose levels (P<0.01), indicating improved conformality with IMRT. Acute and late urinary toxicities were not significantly different for the two methods. However, the combined rates of acute grade 1 and 2 rectal toxicities and the risk of late grade 2 rectal bleeding were significantly lower in the IMRT patients. The 2-year actuarial risk of grade 2 bleeding was 2% for IMRT and 10% for conventional 3D-CRT (P<0.001). Conclusions: The data demonstrate the feasibility and safety of high-dose IMRT for patients with localized prostate cancer and provide a proof-of-principle that this method improves dose conformality relative to tumor coverage and exposure to normal tissues. (C) 2000 Elsevier Science Ireland Ltd. |
| Keywords: | adult; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; major clinical study; androgen; clinical trial; intensity modulated radiation therapy; treatment planning; cancer radiotherapy; comparative study; neoplasm staging; controlled clinical trial; nephrotoxicity; radiation response; risk assessment; prostate cancer; prostatic neoplasms; leuprorelin; feasibility studies; rating scale; safety; radiotherapy planning, computer-assisted; radiotherapy, conformal; bicalutamide; acute toxicity; computer assisted radiotherapy; radiation dose distribution; histogram; prostate carcinoma; rectum hemorrhage; three-dimensional conformal radiation therapy; late toxicity; humans; human; male; priority journal; article; inverse treatment planning |
| Journal Title: | Radiotherapy and Oncology |
| Volume: | 55 |
| Issue: | 3 |
| ISSN: | 0167-8140 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2000-06-01 |
| Start Page: | 241 |
| End Page: | 249 |
| Language: | English |
| DOI: | 10.1016/s0167-8140(99)00100-0 |
| PUBMED: | 10869739 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 18 November 2015 -- Source: Scopus |
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